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Review of Kinesio Taping ignored other models and techniques
Journal of Physiotherapy 60 (2014) 176–177
Journal of
PHYSIOTHERAPY journal homepage: www.elsevier.com/locate/jphys
Appraisal
Correspondence
Review of Kinesio Taping ignored other models and techniques A systematic review of randomised trials of Kinesio Taping was recently published in Journal of Physiotherapy by Parreira and colleagues.1 The methods used were very thorough and I congratulate the authors for their great job and for having had the insight to look at all the available evidence in as many languages as possible. My main problem with the title and conclusion is that only two of the more than 10 taping possibilities were used in the appraised articles. One was the ‘muscle technique’, which involves taping from origin to insertion or vice versa to stimulate or inhibit the underlying muscle. The other was the ‘star application’, which is intended to lift the skin. These taping methods are examples of the original model of taping developed by Kenzo Kase. However, the authors used this evidence to mistakenly conclude that all Kinesio Taping techniques and models do not work. It seems that the authors have not taken into account that there are many other schools of thought as to how and why Kinesio Taping works. This tape is used and applied in many different ways around the world. For at least a decade, allied health professionals have been using tape in a number of ways: according to the original ideas of Kenzo Kase (original model); using the concept that the fascia is involved through ‘biotensegrity’ to tape according to ‘fascia lines’ and ‘muscle trains’ (fascia model); using the concept that skin and brain are involved through mechanical and sensory stimuli (skin model); using alternative methods such as taping meridians, Chi and chakras (energy model); and combining Mulligan, Maitland and McConnell tape applications in various manners (combination model). Recent studies of the hypotheses of the original model have found no significant differences in effect due to direction of tape.2,3 No evidence of a skin-lifting effect of the star application has been found. Two studies have shown that tape properties differ by brand and colour.4,5
Elastic therapeutic tape can be used in many ways and the results of other models (eg, skin model) have recently been published. For example, elastic tape applied to the knee can have profound effects on neuromuscular control.6 Guimberteau7 has shown that skin always returns to its original shape and size after being manipulated, and Fukui8 has demonstrated that the skin moves in a specific physiological direction in the extremities and trunk. Taping the skin affects these skin properties. Currently, numerous professionals persist in using this tape because of the perceived positive effect in the daily clinic. On the other hand, researchers are telling us that it doesn’t work. We must be missing something. Is it time for clinician and researchers to team up? Esther de Ru GoPhysio, Zutphen, The Netherlands References 1. Parreira PdCS, et al. J Physiother. 2014;60:31–39. 2. Lee Y-Y, et al. The effect of applied direction of kinesio taping in ankle strength and flexibility. In: 30th Annual Conference of Biomechanics in Sports, Melbourne. 2012; 140–143. 3. Luque Saurez A, et al. Man Ther. 2013;18:573–577. 4. Ferna´ndez Rodrı´guez JM, et al. Apunts Med Esport. 2010;45:61–67. 5. Aguado Jodar X, et al. Mechanical behaviour of functional tape: implications for functional taping preparation. In: 13th Annual Congress European College of Sports Science, Portugal. 2008. 6. Konishi Y. J Sci Med Sport. 2013;16:45–48. 7. Guimberteau J-C. The skin excursion. Sept 2009. http://www.endovivo.com/en/ [accessed 17-05-2014] 8. Fukui T. Skin movement of the trunk during trunk rotation. In: World Congress of Physical Therapy Conference. 2011; RR-PO-203-1-Thu.
http://dx.doi.org/10.1016/j.jphys.2014.06.014
Different models and techniques of Kinesio Taping have never been tested We appreciate the opportunity to comment on de Ru’s opinions and interpretations of our systematic review, which aimed to evaluate the efficacy of Kinesio Taping in people with musculoskeletal conditions,1 and to respond to the issues that she raised. In her letter to the editor, de Ru claims that there are multiple Kinesio Taping models and techniques that can be used, and that the eligible articles included in our study just evaluated the ‘original Kinesio Taping developed by Kenzo Kase’ and we ‘mistakenly concluded that all Kinesio Taping techniques and models do not work’. She then presents references for supporting these other models, claiming that they might work. We do not support the idea that we ignored other Kinesio Taping models, as we selected all articles that used any model of Kinesio Taping in people with musculoskeletal conditions. We used comprehensive search strategies, following the recommendations from the Cochrane Collaboration, and we are confident that all available evidence on the use of Kinesio Taping for this
population was included. Our conclusions are based upon these 12 eligible randomised controlled trials and our interpretation was balanced using the GRADE recommendations. These other Kinesio Taping models, to the best of our knowledge, have never been tested in randomised controlled trials (therefore these models were not even mentioned in our review). The seven references provided by de Ru are conference presentations (ie, not published in peer-reviewed journals), studies of mechanisms, and a randomised trial conducted in asymptomatic subjects (the results cannot be generalisable for people with musculoskeletal conditions). Therefore, the arguments that these other models might work are not based upon highquality, clinical research. These models and techniques are only theoretical and not evidence-based. As responsible researchers, we would never recommend something that has never been tested. Finally, the statement ‘Currently, numerous professionals persist in using this tape because of the perceived positive effect
1836-9553/ß 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
Journal of
PHYSIOTHERAPY journal homepage: www.elsevier.com/locate/jphys
Appraisal
Correspondence
Review of Kinesio Taping ignored other models and techniques A systematic review of randomised trials of Kinesio Taping was recently published in Journal of Physiotherapy by Parreira and colleagues.1 The methods used were very thorough and I congratulate the authors for their great job and for having had the insight to look at all the available evidence in as many languages as possible. My main problem with the title and conclusion is that only two of the more than 10 taping possibilities were used in the appraised articles. One was the ‘muscle technique’, which involves taping from origin to insertion or vice versa to stimulate or inhibit the underlying muscle. The other was the ‘star application’, which is intended to lift the skin. These taping methods are examples of the original model of taping developed by Kenzo Kase. However, the authors used this evidence to mistakenly conclude that all Kinesio Taping techniques and models do not work. It seems that the authors have not taken into account that there are many other schools of thought as to how and why Kinesio Taping works. This tape is used and applied in many different ways around the world. For at least a decade, allied health professionals have been using tape in a number of ways: according to the original ideas of Kenzo Kase (original model); using the concept that the fascia is involved through ‘biotensegrity’ to tape according to ‘fascia lines’ and ‘muscle trains’ (fascia model); using the concept that skin and brain are involved through mechanical and sensory stimuli (skin model); using alternative methods such as taping meridians, Chi and chakras (energy model); and combining Mulligan, Maitland and McConnell tape applications in various manners (combination model). Recent studies of the hypotheses of the original model have found no significant differences in effect due to direction of tape.2,3 No evidence of a skin-lifting effect of the star application has been found. Two studies have shown that tape properties differ by brand and colour.4,5
Elastic therapeutic tape can be used in many ways and the results of other models (eg, skin model) have recently been published. For example, elastic tape applied to the knee can have profound effects on neuromuscular control.6 Guimberteau7 has shown that skin always returns to its original shape and size after being manipulated, and Fukui8 has demonstrated that the skin moves in a specific physiological direction in the extremities and trunk. Taping the skin affects these skin properties. Currently, numerous professionals persist in using this tape because of the perceived positive effect in the daily clinic. On the other hand, researchers are telling us that it doesn’t work. We must be missing something. Is it time for clinician and researchers to team up? Esther de Ru GoPhysio, Zutphen, The Netherlands References 1. Parreira PdCS, et al. J Physiother. 2014;60:31–39. 2. Lee Y-Y, et al. The effect of applied direction of kinesio taping in ankle strength and flexibility. In: 30th Annual Conference of Biomechanics in Sports, Melbourne. 2012; 140–143. 3. Luque Saurez A, et al. Man Ther. 2013;18:573–577. 4. Ferna´ndez Rodrı´guez JM, et al. Apunts Med Esport. 2010;45:61–67. 5. Aguado Jodar X, et al. Mechanical behaviour of functional tape: implications for functional taping preparation. In: 13th Annual Congress European College of Sports Science, Portugal. 2008. 6. Konishi Y. J Sci Med Sport. 2013;16:45–48. 7. Guimberteau J-C. The skin excursion. Sept 2009. http://www.endovivo.com/en/ [accessed 17-05-2014] 8. Fukui T. Skin movement of the trunk during trunk rotation. In: World Congress of Physical Therapy Conference. 2011; RR-PO-203-1-Thu.
http://dx.doi.org/10.1016/j.jphys.2014.06.014
Different models and techniques of Kinesio Taping have never been tested We appreciate the opportunity to comment on de Ru’s opinions and interpretations of our systematic review, which aimed to evaluate the efficacy of Kinesio Taping in people with musculoskeletal conditions,1 and to respond to the issues that she raised. In her letter to the editor, de Ru claims that there are multiple Kinesio Taping models and techniques that can be used, and that the eligible articles included in our study just evaluated the ‘original Kinesio Taping developed by Kenzo Kase’ and we ‘mistakenly concluded that all Kinesio Taping techniques and models do not work’. She then presents references for supporting these other models, claiming that they might work. We do not support the idea that we ignored other Kinesio Taping models, as we selected all articles that used any model of Kinesio Taping in people with musculoskeletal conditions. We used comprehensive search strategies, following the recommendations from the Cochrane Collaboration, and we are confident that all available evidence on the use of Kinesio Taping for this
population was included. Our conclusions are based upon these 12 eligible randomised controlled trials and our interpretation was balanced using the GRADE recommendations. These other Kinesio Taping models, to the best of our knowledge, have never been tested in randomised controlled trials (therefore these models were not even mentioned in our review). The seven references provided by de Ru are conference presentations (ie, not published in peer-reviewed journals), studies of mechanisms, and a randomised trial conducted in asymptomatic subjects (the results cannot be generalisable for people with musculoskeletal conditions). Therefore, the arguments that these other models might work are not based upon highquality, clinical research. These models and techniques are only theoretical and not evidence-based. As responsible researchers, we would never recommend something that has never been tested. Finally, the statement ‘Currently, numerous professionals persist in using this tape because of the perceived positive effect
1836-9553/ß 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.